We now know how many people have the problem most often cited as the reason for last years’ health overhaul legislation. Answer: 8,000

No, that’s not a misprint. Out of 310 million Americans, only 8,000 people have the problem given as the principal reason for spending almost $1 trillion, creating more than 150 regulatory agencies and causing perhaps 150 million or more people to change the coverage they now have.

Alert readers will remember the White House summer of 2009 invitation to all Americans to send in their horror stories describing health insurance industry abuses. Although the complaints were many, the vast majority were about pre-existing condition limitations. Then, on the eve of the ObamaCare vote, every member of Congress who appeared on television to defend the legislation was able to cite by name an individual or family in his or her state or Congressional district with a heart wrenching story.

Gone was any interest in “universal coverage” or “insuring the uninsured” or “helping poor people get health care.” The case for change was focused almost exclusively on protecting the middle class from miserly insurance companies.

Although the most important parts of ObamaCare (the individual mandate, subsidies, employer fines, etc.) do not kick in until 2014, the legislation made interim provision for those with pre-existing conditions problems. A new kind of risk pool is open to anyone who is denied insurance in the private sector and it’s available for the same premiums healthy people pay. Twenty-three states are operating their own risk pools and 27 are relying on a federal plan.

It’s been like giving a party to which no one comes. The Medicare program chief actuary predicted last spring that 375,000 would sign up for the new risk pool insurance in 2010. But by the end of November, only 8,000 had done so. As Amy Goldstein reports in The Washington Post, this includes 75 in Virginia, 80 in New Hampshire, 97 in Maryland and a whopping 700 in North Carolina.

While a lot of people are surprised by these numbers, I am not. Here is why. Don’t you think it is a bit odd for the White House to send out an appeal to victims so they can identify themselves? That’s not normally how the political system works.

The more usual scenario is: victims unite and form interest groups; they lobby Congress, write letters, testify, etc; and eventually the pressure become so great that Congress legislates.

When have you ever heard of that entire process in reverse? When has Congress ever before decided it wants to do something and then conducted a nationwide search to find people who will benefit?

The reasons for the reversal is that this whole problem has been completely hyped and exaggerated from the get go. In this country we have made it increasingly easy for people to get health insurance after they get sick. Going to work for an employer with generous health benefits, for example, is the most direct way.

Of course that system will miss people who are too sick to work. And that may explain why the few who are signing up appear to have very high medical expenses. Even though they have less than 1/40th of the expected enrollment, the plans are already running out of the money.

Meanwhile, as I’ve said before, the beneficiaries of reform are few, scattered and largely invisible.The cost of reform is falling on people who are numerous, somewhat organized and very vocal. That is why I think the prospects for reform of the reform are quite good.

For years public health advocates, progressives and activists from the Left Wing of the Democratic Party have been advising left-of-center politicians to campaign on a platform of universal coverage. They would fund poll after poll, in which individuals would voice (theoretical) support for universal coverage (assuming it would be paid for with other-people’s-money). Then, after every election, the activists would wring their hands and lament that health reform (i.e. universal coverage) failed to become a significant issue in the election.

The activists finally got a majority in Congress and a President who listened to them. But they had to reshape their message to one more people would be sympathetic to. When 85% of the population already has coverage (and 5% of those that don’t have access to Medicaid or employer coverage), campaigning on universal coverage doesn’t get much traction.

But reshaping the message to one where evil insurance companies are denying people cheap coverage (or the treatments people deserve) is fear mongering that resonates with more people even if they have coverage and have never faced these problems.

Now a slight majority of voters worries that the ACA was forced upon them and the new law may have some costs they were never told about.

I think Devon just countered the assertion that the administration went out “looking” for victims instead of interest groups forming and demanding a change.

I also think using the total number of enrolled in the high risk poolk is not a legitimate estimate of the need also. What about cost? or How many states have their high risk pool up an running and taking applications instead of the planning stage?

In answer to Greg,
As I’ve said before and many others- Health Care reform is not about health care, it’s about command and control. It doesn’t matter to them how many “need” something, it only matters to make them dependent on the gov’t programs. We are headed to universal gov’t run health care unless Obamacare is repealed and replaced.

For comparison, in 2006 one estimate suggested lifetime cost of treating HIV was less than $700,000. Dialysis cost about $66,000 a year in 2002. Hemophilia can push costs to $100,000 a year, mostly for clotting factor. A severely ill person in a nursing home could cost more than this in some years, if one includes the cost of care that is not paid for by health insurance.

At a simple interest rate of 1%, investing $125,000,000 per person would throw off $1.25 million per person per year with no change in the principal.

In addition, they have guaranteed continuing acceleration in the upward movement on medical pricing. Competition among insurance companies will decrease as the MLR regulations force carriers to shut down. More people under third party payer plans means less competition among providers. Nothing good is coming of this act.

Actually, the reason these so called polls in the past have indicated a public appetite for “universal” healthcare is simple. People were being told (or they assumed) that their seemingly out of control healthcare costs would be reduced under a system of government control.

Aside from the fact that these polls and the questions asked were poorly constructed, the primary concern from the public has been and will continue to be the cost factor. Now that it is becoming clear that “universal” healthcare will actually be quite more expensive a whole new perception dynamic is taking over. People are beginning to understand that the only way universal healthcare can reduce cost is if that healthcare is rationed, and all the spinning and fact deflecting in the world is not going to neutralize that poison pill.

Frank, I doubt if the polls were poorly constructed. I suspect the proponents of these polls invested considerable funds in polling experts to have the questions constructed in such a way; and the answers “focus-grouped” to ensure the “results” would be to their liking! 😉

There is another – IMHO more frustrating – story that can be told with these numbers: the people who most needed this coverage were the least able to navigate the bureaucracy. This can be because of lack of time, low education, lack of expertise in understanding government forms, etc.

I’m not defending the policy, but saying that we have to remember that many of these programs are wasted because Leviathan necessarily creates ineffective distribution mechanisms.

For example, how many people after doing their own taxes have the suspicion they have done something wrong. I know I do, every single year. Thank goodness, I don’t have a pre-existing condition (knock wood), but if I did, I doubt I would be able to easily apply and receive benefits. Read Coase, we ignore transaction costs at our own peril.

The Econtalk interview with Katherine Newman (http://www.econtalk.org/archives/2010/03/newman_on_low-w.html) has some fascinating stories of working poor who needed people to shepherd them through the paperwork and hassle to get access to government programs. While that might seem a bonus to some – less handouts that way – it’s disgraceful to have needlessly wasteful processes in place. How much money is spent *preventing* people from receiving access to these programs? Either have the (health, education, childcare, whatever) program, or don’t.

John–you are totally right. Instead of fighting this awful reform plan, I have written a “Blueprint” of what we need to do instead. If you would like a copy, contact me by e-mail. It is 4.5 megs. But it takes into account the total system and a multi-decade adaptation program.

Your conclusion is totally invalid-just because only 8,000 have signed up SO FAR, has ZERO correlation with the actual number of Americans who are denied or cannot afford coverage for pre-existing conditions. Just ask any Type 1 diabetic. Yoy are certainly entitled to point that only 8,000 had signed up as of 11/10, but to categorically state that there are “only 8,000” persons in the U.S. who require such coverage is deceptively hyperbolic rhetoric at best if not an outright calumny.

JG, you are an OBOT troll. Anyway since you love this obotcare you will be “required” or jailed or fined for not buying this obotcrap so don’t gripe about affording the coverage. If you will read this again you will see that you aren’t punished for your pre-existing condition, if you really have a pre-existing condition. You can pay the same premium as anyone else under obotcare, but you HAVE TO BUY IT OR GO TO JAIL or BE FINED THROUGH THE NOSE.

I have to agree with JG. N.B. JG’s comment doesn’t identify him as either pro- or anti-Obamacare.

I guess my biggest concern at this point is that the Republicans manage to cripple PPACA without advancing anything in its place, giving the Dems an excuse to push for single-payer the next time the pendulum swings.

Bart writes, “I guess my biggest concern at this point is that the Republicans manage to cripple PPACA without advancing anything in its place…”

The GOP will have plenty of reform proposals to “replace” the current abomination. In fact, there were proposals put forward by the GOP during the 45 second period when the Dems were debating this health bill. It’s just few in the public had a chance to see them because the democratic majority (and the media) did not allow it to happen.

And even if there were no replacement for the repeal of this law we would be much better off with what we had before. It is not helpful to allow yourself to fall into this media group think mantra that the GOP only wants to undo PPACA without taking the opportunity to do something positive. The simple fact is the Republicans have not had the opportunity (even under George Bush) to do anything because of the lack of support numbers. Until that changes (hopefully in 2012) the GOP will absolutely not be able to pass any positive legislation, but it can stop future and de-fund existing bad legislation. And it seems that should be the first priority.

You are being simplistic or purposely biased if you think the only reason the reform was passed was to cover pre existing conditions. What about the MILLIONS of people who cant afford health insurance? What about trying to reign in costs? To pick one very small part and use it to judge the whole bill is just silly.

Over 35% of my income went to health related expenses last year and I do have insurance. Something has to change. You are very naive to think you can go back to where we were and then start over. Look how much trouble it was to just get to this point.

The message last spring from all the supporters was clear, uniform and focused (not surprising; it was probably developed form focus groups). The only argument advanced was: pass this bill to protect people from insurance companies.

The problem with “taking people at their word” is that most people have an agenda and will use misconceptions, sound bites, and outright untruths (lies) to get their point across. For example “death panels” which is nothing more than a doctor telling a terminal patient what his options are such as hospice, intense measures to prolong life or others. Its not a government panel deciding who lives and dies.

Here in Arizona the Governor and legislature (Both Republican controlled) cut the state version of medicare and people have died because of it (It was on the news). Now you tell me what is more of a death panel, a doctor telling a dieing patient what his options for care are or the government deciding what programs to cut?

The whole “death panel” thing was used to swing public opinion against health care reform. Who’s “word” should we take?

Gene, there is no need in health care overhaul for healthy people without insurance coverage. I have been on this situation before. Ended up occasionally with several hundreds liability. All negotiated in partial monthly payments. BIG DEAL!!!

People with pre-existing conditions are those that actually need real help. But even if you apply 8000 by a 1,000 the total won’t justify $1T price tag for Obamacare.

Insurance costs is the problem that can be addressed separately, but not at the expense of individual mandate to buy coverage. It is just disgusting to force someone to buy a product he doesn’t need. Don’t you think?

My problem with the article is using the 8,000 figure to judge the whole bill. Do you even know what the changes are that have gone into effect already or is this the only information you are basing your entire argument on?

Here are some of the changes that have already gone into effect.
1. Coverage expansion for adult dependents until age 26.
2. Children no longer denied coverage for pre-existing conditions
3. Prohibit insurers from rescinding coverage
4. Free Preventive Care
5. No lifetime limits on coverage
6. Unrestricted doctor choice
7. Some seniors are now qualified for a 50% discount on prescriptions covered by Medicare Part D
8. requires insurance providers to spend 85% of premiums on health care.

So are any of the changes above evil? Terrible? Sinister? If this whole thing wasn’t so political, something really good could have come out of this. Instead we get something that no one is really happy with.

FYI – That Trillion dollars is over 10 years so it is 100 billion per year.

1. Calling adults “children” up to the age of 26?
2. Insurance companies dropping their stand-alone children’s policies?
3. Insurance companies can’t rescind coverage, even if obtained by fraud?
4. Free preventative care – someone pays for it, so it’s not “free.”
5. No lifetime limits – okay, if insurers are allowed to increase premiums in anticipation of higher costs.
6. Ha! Many doctors already do not accept Medicare patients due to the low reimbursements for treatments; others plan to retire rather than work as slaves to the state. How will this improve health care?
7. Seniors are, in general, the richest Americans. Poor seniors can get FREE drugs from pharmaceutical companies if their doctors vouch for their economic situation. Why are we subsidizing rich seniors and pharmaceutical companies? (I am a senior, by the way.)
8. What other business — in THIS country — is told what they may spend in overhead and profit? Competition among insurers effectuates efficiency and keeps premiums as low as possible.

The Democrats had complete control of the law-making function of the federal government when this bill was cobbled together and passed. Republicans could stop NOTHING. No Republican proposals were considered; they were rejected out of hand. So what we have is what the Democrats wanted: a system in which private insurance companies will be unable to continue to operate, so that eventually the federal government will have to step in and take over the entire healthcare delivery system. The federal government does NOTHING efficiently. Healthcare is in trouble if this bill lives.

FYI – Money will flow into this new system for two years before most of the “benefits” begin, this in order to maintain the illusion that it will “only” cost a trillion dollars. The cost of Medicare grew at a rate several times the rate that was predicted at its passage. Do you think ObamaCare will be any different?

1. How old is your “child” when they are still in college?
2. Children denied coverage as part of family coverage.
3. Oh come on now.
4. It is cheaper to prevent an illness than to treat it! It saves everyone money!
5.
6. All insurance plans now allow you to see any doctor covered under that plan not just medicare.
7. “Some” seniors. It is based on income. (You are making my point of condemning something without knowing the facts)
8. There are a lot of businesses that are under similar guidelines.

If you think Democrats had full control you don’t understand the power of the senate filibuster. Health Care is in trouble with our without this bill.

I am an Independent (ex republican) because i am capable of thinking independently of the mantra of the political parties. I read the health care bill. I looked up the facts and did not go by the sound bites or political arguments.

“For example “death panels” which is nothing more than a doctor telling a terminal patient what his options are such as hospice, intense measures to prolong life or others. Its not a government panel deciding who lives and dies.”

Way off base… You describe the current process whereby doctors and patients converse on options… The reality is that “death panels” already exist in all government rationed healthcare programs (England, Canada, France, etc.). The bureaucracy of these inefficent systems forces them to ration, making hard decisions on who will utlimately lose opportunity to receive the “intense measures to prolong life”.

The ObamaCare ‘effect’ is already causing the administration’s desired results… (re: Polly’s post). They always had full intention, and still do, of forcing insureance companies out of the market and becoming the backfill.

You are wrong, and repeal is the best thing to save us from this monstrosity. The follow-up is modifications or creation of much more realistic solutions (already formulated or in process by the Republicans and some Dems).

Health care, like most things in life, is rationed by whoever pays for it. Who do you want to ration your health care? I prefer to ration mine, which means avoid third party payers to the greatest extent possible. High deductible insurance achieves the goal and reduces cost significantly. Simple. Effective.

Death panels: Why is the government telling physicians exactly how to talk to patients regarding end of life care? Physicians already do that and they are the ones that best know the patients needs and fears. Long ago there was a code number provided by Medicare to handle conversations of this nature or conversations with families etc. That number permitted doctors to bill for time.

Thus, why all of a sudden is there this emphasis that sounds almost as if the government is nudging people to terminate their lives earlier than they would otherwise do? Does government feel that too many people opted to stay alive? It certainly sounds that way.

“The ObamaCare ‘effect’ is already causing the administration’s desired results… (re: Polly’s post). They always had full intention, and still do, of forcing insureance companies out of the market and becoming the backfill.”

What facts do you base your statement upon? What health insurance company has gone out of business or is in financial trouble? What bad effects in any regard has occurred?

Its all political rhetoric unless there are any facts to back up the statement. Even using the words “Obama Care” is nothing but political speak. Can you come up with actual facts or are you relying on the Fox News sound bites?

Francis’s quote contains a factual rational statement. Can you do the same for your position.

Frank Timmins writes: “In fact, there were proposals put forward by the GOP during the 45 second period when the Dems were debating this health bill.”

Sure, they had proposals. Too little, too late. The GOP had 15 years to address the employer monopoly issue, but never managed to come up with a proposal that wouldn’t have kicked 70 percent of non-elderly adults out of their group plans. The closest I’ve seen to a fully thought-out proposal was Senator Enzi’s plan, but I don’t think it got very far within the GOP let alone outside the party.

I am not a citizen of the USA but as a market observer, I have this to say: the reform of your healthcare reform is bound to happen, naturally, after the reform has run its course, just like the reform itself came about after the previous course ran itself out -your healthcare market had swung to one extreme losing sight of the product (health is a common property) and this reform swings it back, which it will duly to other extreme losing sight of the product (health is a personal experience). Going by the discourse at the start of this reform it looks like you are on track to get the reform of this reform when it gets due. If you are any smart of a Republican democratic country you would keep the discourse going. 🙂

“The Democrats had complete control of the law-making function of the federal government when this bill was cobbled together and passed. Republicans could stop NOTHING. No Republican proposals were considered; they were rejected out of hand. So what we have is what the Democrats wanted: a system in which private insurance companies will be unable to continue to operate, so that eventually the federal government will have to step in and take over the entire healthcare delivery system.”

There’s this thing called the filibuster which Republicans used throughout the healthcare debate. The law that passed was almost exactly like the Nixon, 1992 Republican(vs. Clinton), and the MA (Romney) health care proposals.

The Republicans offered *no* credible alternatives to any Democratic proposal and went all out to block reform. I’m not sure how private insurance companies are being driven out of business if everyone is required to buy from private insurers. That whole ‘public option’ thing was removed from any Democratic proposal.

So, in short, if you don’t have employer sponsored insurance after 2014, you must buy insurance from a private company unless you get medicare or medicaid. Yep, that’s commu/social/fasc-ism at it’s finest.

Well, aren’t you all so smug. Go ahead and twist the facts all you like. The originator or this article certainly did:
We now know how many people have the problem most often cited as the reason for last years’ health overhaul legislation. Answer: 8,000
I see, because only 8k have tried to get insurance through their state’s “pre-existing condition” health plan, does in no way mean there are only that many people who have this situation, and I am certain you are all aware of that. Just do a little research on your own, and you’ll find plenty of factual information that will tell you there are hundreds of thousands, if not millions, of people with pre-existing conditions. But don’t let the facts get in the way of your fun party here.
“A new kind of risk pool is open to anyone who is denied insurance in the private sector and it’s available for the same premiums healthy people pay.”
Oh really, where are you getting your facts, Mr. Goodman. I don’t see you site any proof of what you’re claiming here. Has Mr. Goodman investigated this at all? Or just relying on third party, pro-GOP dogma?
This is directly from the article Mr. Goodman is linking to in his article, regarding the amount of people who’ve signed up:
“Federal health officials contend the new insurance plans, designed solely for people who already are sick, are merely experiencing growing pains. It will take time to spread the word that they exist and to adjust prices and benefits so that the plans are as attractive as possible, the officials say.

State-level directors of the plans agree, in part. But in interviews, they also said that the insurance premiums are unaffordable for some who need the coverage – and that some would-be customers are skittish about the plans because federal lawsuits and congressional Republicans are trying to overturn the entire law.”
Maybe all of you who have health insurance readily available to you, have no pre-existing conditions, and have no need to have the health overhaul, because “you’re taken care of” already, should sit down and shut up. There are plenty more than 8,000 out there, and you should all be ashamed of yourself for following along like lemmings to a person who’s obviously anti-health reform (he’s probably taken care of too).

The purpose of insurance is to protect the insured from paying the cost of a risk when the risk has occurred. A preexisting health condition is not a risk; it is a liability. Therefor it is not insurable by the common definition of insurance.

For a risk to be insurable: A potential claim must be substantial, a potential claim must be rare, and both the insurer and the insured must be committed to avoidance of claims. Preexisting conditions fail to satisfy these criteria of insurability.

Bart I, I am confused. You say the GOP had 15 years to address the employer (healthcare) monopoly issue. I assume you believe that employers should not be involved. But Obamacare is all about employers’ involvement.

I agree that Enzi had some good ideas, but you don’t seem to grasp the reality of politics. Pelosi was not about to let Enzi’s, Coburn’s or any other GOP ideas see the light of day in the House of Representatives.

You may remember that Bush tried to start the reform process for SS (and then Medicare) which would surely have led to overall healthcare reform. He was cut off cold by the democrats. There has really been no chance for conservative healthcare reform in the last 15 years (or 50 years for that matter).

[re:forcing insurance companies out of the market]
“I’m not sure how private insurance companies are being driven out of business if everyone is required to buy from private insurers.”
“What facts do you base your statement upon?”

Keith and Gene, let Ezra Klein bring you up to date on that. First, some background: Barney Frank, author of single-payer:http://www.youtube.com/watch?v=QLm9t9j-qKM
John Kerry gives thumbs-up to Barney Frank’s point:http://www.youtube.com/watch?v=-522hcm3woA
Settled: Leftists intend for a public option to lead to single-payer but the American people are too satisfied with their private plans to want a public option. But other people only exist to be molded by Leftists, who we know have superior wisdom and virtue…
So Ezra Klein explains the role of ObamaCare in all this:http://www.youtube.com/watch?v=FElipqE_Dl4
So repectful of the will of the American people, aren’t these Leftists? All those secret designs they have for us…
So Obamacare leads to a terminally dysfunctional private insurance industry via the mandates/restrictions imposed on companies and the incentives it creates. How many will die during this transitory phase? Just look at past Leftist experiments, dummies! Mao… Stalin… But it’s just a transition and it’s all for the Collective Good, ya know.

With ObamaCare, private insurance is now an insolvent business model because it isn’t insurance anymore. It’s mandated by government to become welfare and so it will follow the economic path of all welfare systems. Investers will pull out as the government doesn’t allow a return as it does in other industries. As for the incentives, it’s now geared toward croney capitalism–medical workers aiming to please government overseers, instead of pleasing patients with the right to withhold their money and to sue over corrupt practices–those rights are stripped from us when government runs the show.

“See how greedy and corrupt the people in private medicine are?” The corruption that will fester among private companies with ObamaCare is intended to lead to an uproar for a public option. The public option would then do exactly what Barney Frank and John Kerry say it would; put private insurance out of business.

The result of all this is that we will all be reduced to idiots with a vote that we are all to view as our Health Care Lifeline. Better use it wisely! Outside of our vote, healthcare will be out of our hands and in the hands of our ruling-elitist betters. A demented teen is flying this airliner!

Just because 8,000 people have signed up means nothing. It’s like asking stupid people to sign up for a course to reverse their stupidity. Because they don’t sign up doesn’t mean they aren’t stupid. This is a statistic that means nothing. Here’s another one…almost 45% of violent crimes are committed by people wearnig jeans. I guess we should outlaw jeans and there won’t be violent crime. How many of you astute conservatives fell for this?

Ok im one of those whom just rescently discovered plan B, I dont have to wait ill 2012 or 2014, Im currently applying, my doctor, physical therapist & multipal pharmist, none new of this option, I applied for rescent health insurance,a pre existing ad, 33,000 per yr. They stated there was no plan b i was miss informed,,,,, i believe your study is greatly flawed…… people don’t KNOW..This is the biggest secret passed

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